The purpose of this study is to examine the perception of spacing births in relation to maternal health by husbands, wives and their families living in the rural communities of the Philippines. Short birth intervals of less than one year between live births is a high-risk factor in fertility behavior in the Philippines. The Southeast Province of Luzon (Philippines), the site for the study, is one of the regions that do not report birth intervals or pregnancy related complications. Research aims include: (1) to analyze the cultural perception of maternal health related to birth spacing by rural Filipino couples; (2) to describe the cultural perception of family members regarding maternal health; and (3) to discover the factors influencing decisions to birth space. An ethnographic methods approach will be used to understand the emic viewpoints of Filipino couples and their families concerning spacing of births related to maternal health using participant observation, field notes, and in-depth interviews in venues chosen by participants and in rural health clinics, social events, and in other settings as available. Participants will be interviewed and audio-taped with data translated and transcribed into English for analysis and back-translated into Bicol or Tagalog for accuracy. The product of analysis will consist of categories and themes describing the cultural context of birth spacing as it relates to maternal health.